- The Washington Times - Tuesday, November 11, 2008

Veterans of the wars in Iraq and Afghanistan once faced mold, mouse droppings and other squalid conditions at the Walter Reed Army Medical Center in the District, but in three years, they are assured of being treated in private patient rooms filled with daylight and fresh air.

Walter Reed is merging with the National Naval Medical Center (also known as Bethesda Naval Hospital) as the result of the 2005 Base Realignment and Closure recommendations, aimed at streamlining military installations. Under construction on the naval hospital’s 243-acre campus off Wisconsin Avenue is a major expansion to provide health care facilities for all four military branches.

In the newly configured Walter Reed National Military Medical Center, doctors will treat everything from post-traumatic stress disorders to prosthetic enhancements in “green” architecture respectful of the art-deco hospital.

New buildings for outpatient and critical care services, totaling about 682,000 square feet, are rising to either side of the naval hospital’s iconic tower and will be completed in September 2011. At the same time, 450,000 square feet of renovations will be carried out to integrate existing clinical and diagnostic spaces into the expansion.

On the southern periphery of the campus, a separate two-story building for traumatic brain injuries is due to begin construction early next year and may be completed in 2010.

“We have to create a very positive healing environment throughout the buildings to better serve the patients,” says architect John Richardson of District-based HKS Inc., the health care design firm fine-tuning the main additions. “This is going to become a teaching hospital, the equivalent of the Johns Hopkins for the military.”

For Mr. Richardson and the other architects involved in the $640-million project, the challenge has been to develop state-of-the-art health care facilities while respecting the naval hospital’s outdated art-deco architecture, which is listed on the National Register of Historic Places.

The vision for the original campus began with President Franklin D. Roosevelt, who sketched his idea on White House stationery. Roosevelt’s stepped tower was inspired by the 400-foot-tall Capitol in Lincoln, Neb., designed in the 1920s by architect Bertram Goodhue.

French-born Paul Cret - the architect of the Pan-American Union Building, Folger Shakespeare Library and Federal Reserve Board Building in the District - was tapped to work with the Navy’s architectural staff and develop a final design. Building One, as the 20-story tower came to be called, was built of concrete and steel from 1939 to ‘42.

“It is Washington’s only skyscraper - not in its height but in its attitude of verticality,” says architect Bill Hellmuth of Hellmuth, Obata and Kassabaum Inc. in Georgetown.

Mr. Hellmuth and his team conceived the initial plan to bookend the tower with two large additions. “We didn’t want to upstage the original architecture, so we created symmetrical massing that was deferential to the tower,” the architect says.

District firms Hartman-Cox Architects and HKS further developed the scheme for builder Clark/Balfour Beatty to meet the approval of the National Capital Planning Commission, which gave its go-ahead in June.

Building A, the six-level outpatient facility to the north, will include an amputee center, physical- and occupational-therapy rooms, a pediatric and family-practice section and a cancer center.

To the south, Building B will extend from a boxy medical center known as Building 9, which was added to the naval hospital in 1980. The new addition will upgrade the existing emergency room along with facilities for nuclear medicine, cardiology and intensive care.

Patient rooms in this wing will be single-occupancy and fitted with lifts to carry the sick from beds to toilet rooms.

A 943-space parking garage will be built behind Building A to help accommodate the influx of an additional 1,860 visitors to the future military medical center on a typical weekday.

From Wisconsin Avenue, the new structures will appear similar to the four-story wings flanking the historic tower. Their precast concrete facades feature metal panels and windows arranged with a vertical emphasis, similar to Mr. Cret’s deco architecture. The new concrete panels will be slightly darker than those of the older buildings to allow the tower to remain visually prominent.

Less faithful to the Roosevelt-era architecture but more striking in its sinuously curving glass exterior is the National Intrepid Center of Excellence to the south of Building B. Its sleek, transparent architecture counters the sealed-up image typical of military installations.

The sole purpose of the 76,000-square-foot building, designed by the District’s Smith Group, is to diagnose, treat and research traumatic brain injuries and psychological damage suffered by soldiers returning from Iraq and Afghanistan.

“One in five troops has experienced a traumatic brain injury. This has been called the signature wound of the Iraq war,” says architect and medical planner Lora Schwartz. “We had to create architecture that is quiet, soothing and not distracting. Materials and color palettes couldn’t be jarring or confusing.”

The $68-million building is the brainchild of the New York-based Intrepid Fallen Heroes Fund, a not-for-profit organization responsible for a similar facility at the Brooke Army Medical Center in San Antonio. It will accommodate groups of 24 to 30 patients who are referred to the center for an extensive two-week evaluation of their injuries.

The two-story building combines an L-shaped, concrete-clad structure housing clinical, research and administrative spaces and a undulated, glass-enclosed wing for patient rehabilitation and meetings.

“The L-bar follows the proportions and materials of the existing campus, while the organic shapes talk about the future,” says design architect Michael Kang.

At the heart of the transparent hall will be a 120-seat auditorium and a conference center where doctors and scientists can study and discuss 3-D images of the brain.

Adjacent to the meeting spaces, a round room with a movable floor and video screens on the walls will be used to evaluate a patient’s balance and coordination. Called a computer-assisted rehabilitation environment, this circular chamber is similar to a flight simulator in immersing patients in a virtual-reality experience so they feel as if they are on a plane or a boat.

On the second floor, an apartment fitted with a kitchen and bathroom will enable wounded soldiers to relearn daily living habits. A two-story skylit space dubbed “Central Park” will feature a theater in the round and a meditative space with a labyrinth inscribed on the floor.

All the new buildings on the Bethesda medical campus are expected to receive a silver rating from the U.S. Green Building Council’s Leadership in Energy and Environmental Design program. Among their resource-conserving features are energy-efficient windows, daylit interiors to reduce artificial illumination and the latest heating and cooling systems.

“We wanted to create architecture that is clearly of today,” Mr. Hellmuth says. “This will be done without upstaging the campus in which the tower remains a jewel.”

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